Clinical evaluation of a prototype multi-bending peroral direct cholangioscope
- Authors
- Itoi, Takao; Reddy, D. Nageshwar; Sofuni, Atsushi; Ramchandani, Mohan; Itokawa, Fumihide; Gupta, Rajesh; Kurihara, Toshio; Tsuchiya, Takayoshi; Ishii, Kentaro; Ikeuchi, Nobuhito; Moriyasu, Fuminori; Moon, Jong Ho
- Issue Date
- Jan-2014
- Publisher
- Blackwell Publishing Inc.
- Keywords
- endoscopic retrograde cholangiopancreatography (ERCP); peroral direct cholangioscopy
- Citation
- Digestive Endoscopy, v.26, no.1, pp 100 - 107
- Pages
- 8
- Journal Title
- Digestive Endoscopy
- Volume
- 26
- Number
- 1
- Start Page
- 100
- End Page
- 107
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/12572
- DOI
- 10.1111/den.12082
- ISSN
- 0915-5635
1443-1661
- Abstract
- BackgroundAlthough peroral direct cholangioscopy (PDCS) is emerging as an alternative to traditional mother-daughter cholangioscopy, it is associated with high failure rates. The aim of the present study was to evaluate the ability to insert and carry out interventions using a prototype multi-bending PDCS. Patients and MethodsProspective, observational clinical feasibility study was done in 41 patients with a variety of biliary diseases. A multi-bending PDCS prototype was inserted using a free-hand technique, a guidewire alone, or with a 5-Fr diameter anchoring balloon. Diagnostic and therapeutic procedures were carried out. ResultsThe free-hand direct insertion technique failed in all attempted cases (n=7). Of the remaining 34 cases, successful rate of PDCS insertion into the distal bile duct was achieved by passing the PDCS over a guidewire alone (n=6) and/or with a guidewire plus anchoring balloon (n=28) for an overall successrate of 88.2% (30/34). In 13 (92.9%) patients without an underlying biliary stricture, PDCS insertion proximal to the bifurcation was possible. In 25 cases, biliary interventions were attempted including biopsy (n=13), stone removal (n=6), stent removal (n=1), and intraductal electrohydraulic lithotripsy (n=2) and were successful in 22 (88%). Other than two patients with procedure-related cholangitis with a mild grade of severity, no complications were observed. ConclusionsUsing a novel multi-bending prototype peroral direct cholangioscope, cholangioscopy had a high diagnostic and therapeutic success rate only when passed over a guidewire and anchoring balloon but not with the free-hand insertion technique. Comparative studies of direct cholangioscopy are warranted.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - College of Medicine > Department of Internal Medicine > 1. Journal Articles
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.